Previously, clinical trials that involved dupilumab have taken a cautious approach by excluding patients from receiving live vaccines. This precaution was reflected in the package insert that advises against administering live vaccines to individuals who undergo treatment with dupilumab. This recommendation was to prevent any potential adverse effects stemming from the immune-modulating properties of the drug. The recent approval of dupilumab use in treating atopic dermatitis in patients as young as six months has raised concerns on the pediatric patients who typically follow a vaccination schedule that includes live vaccines.
To address this, Jay Lieberman and team undertook this comprehensive systematic review of existing literature to assess the safety and efficacy of vaccinations, particularly live vaccines, in patients treated with dupilumab. The systematic review analyzed data from various studies involving patients who received vaccinations while on dupilumab. The outcomes found that overall, live vaccines were safe for patients on dupilumab and the efficacy of these vaccines was generally not compromised by the medication. This conclusion was further supported by the expert Delphi Panel, which reached a consensus that the use of vaccines in patients on dupilumab is likely both safe and effective.
Thereby, the recommendation for avoiding live vaccines in patients treated with dupilumab may need to be reconsidered. But, a shared decision-making approach is advised to ensure that patients continue to receive necessary immunizations without undue delay, to maintain their overall health and protect against preventable diseases.
Reference:
Lieberman, J. A., Chu, D. K., Ahmed, T., Dribin, T. E., Abrams, E. M., Anagnostou, A., Blumenthal, K. G., Boguniewicz, M., Chase, N. M., Golden, D. B., Hartog, N. L., Heimall, J. R., Ho, T., Lawrence, M. G., Khan, D. A., Minniear, T. D., Mustafa, S. S., Oppenheimer, J. J., Phillips, E. J., … Greenhawt, M. J. (2024). Use of Vaccines in Patients Receiving Dupilumab, A Systematic Review and Expert Delphi Consensus Recommendation: A position paper of the American College of Allergy, Asthma and Immunology. In Annals of Allergy, Asthma & Immunology. Elsevier BV. https://doi.org/10.1016/j.anai.2024.05.014
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